2015 Annual Training Conference & Anti-Fraud Expo
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Part D Vulnerabilities: A Case Study
(
Room
Seaport C
)
18 Nov 15
2:15 PM
-
3:15 PM
Tracks:
Law Enforcement Path, Pharmacy & Part D Fraud
Speaker(s):
Chris Dunkle, Special Agent, U.S. Department of Health and Human Services, OIG-OI
Faculty will present a case study of a Part D fraud scheme that originated in California, and migrated to Louisiana and Kentucky. The scheme incorporated traditional criminal acts coupled with the use of modern technology to take advantage of program vulnerabilities to divert hundreds of thousands of dollars in prescription non-controlled substances. The case was uncovered by astute local law enforcement that cooperated with federal agencies that investigated and prosecuted the case at the federal level. The scheme, while advanced and relatively well executed, left a digital trail of evidence which helped reveal the nature and extent of the activities.
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